Individual provider Active NPI

Sameer Tolay, MD

  • Hematology & Oncology Physician
  • Fond Du Lac, WI
National Provider Identifier
1376899393
Registry record updated Oct 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
68436 Issued in WI
Practice address
480 E Division St
Fond Du Lac, WI 54935-3734
Phone
(920) 926-4100
Fax
(920) 926-4190
NPI assigned
Jul 27, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 68436 WI Primary

Addresses

Primary practice location

480 E Division St
Fond Du Lac, WI 54935-3734

Mailing address

420 E Division St
Fond Du Lac, WI 54935-4560
Phone (920) 926-8340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180913003447 WI Practitioner - Hematology/Oncology 3577791789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agnesian Healthcare IncGroup PAC ID 1658289624, 392 clinicians

Practice addresses (Care Compare)

480 E Division St
Fond Du Lac, WI 54935-3734
Phone (920) 926-4100

Hospital & facility affiliations

  • SSM Health St Agnes Hospital-Fond Du Lac Hospital, Fond Du Lac, WI, CCN 520088
  • Waupun Memorial Hospital Hospital, Waupun, WI, CCN 521327
  • Ripon Medical Center Hospital, Ripon, WI, CCN 521321

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Agnesian Healthcare, Inc Current Accepting new patients
Agnesian Healthcare Inc CurrentSince Aug 20, 2018 Accepting new patients
Agnesian Healthcare Inc CurrentSince Aug 20, 2018 Accepting new patients

Locations

420 E Division St
Fond du Lac, WI 54935
Phone (920) 923-7400

480 E Division St
Fond du Lac, WI 54935
Phone (800) 236-1428

360 S Mountin Dr
Mayville, WI 53050
Phone (920) 387-2111

835 Parkside St
Ripon, WI 54971
Phone (920) 745-3520

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1376899393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E DIVISION ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549354560",
            "telephone_number": "920-926-8340",
            "fax_number": "920-926-8370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 E DIVISION ST",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549353734",
            "telephone_number": "920-926-4100",
            "fax_number": "920-926-4190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOLAY",
        "first_name": "SAMEER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-27",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "WI",
            "license": "68436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fond Du Lac, WI

Sources for this page

Verify at the official NPI Registry.